肾动脉狭窄：我们应该研究主肾动脉还是节段性血管？
Renal artery stenosis: should we study the main renal artery or segmental vessels?
作者信息
Halpern E J, Needleman L, Nack T L, East S A
机构信息
Department of Radiology, Division of Diagnostic Ultrasound, Jefferson Medical College of Thomas Jefferson University Hospital, Philadelphia, PA 19107-5244, USA.
出版信息
Radiology. 1995 Jun;195(3):799-804. doi: 10.1148/radiology.195.3.7754013.
PURPOSE
To compare the sonographic diagnosis of renal artery stenosis (RAS) with Doppler interrogation of the main renal artery versus Doppler ultrasonography of segmental vessels.
MATERIALS AND METHODS
The main renal artery-to-aortic peak systolic velocity ratio (RAR) and early systolic acceleration in segmental arteries were obtained in 186 patients. Conventional arteriographic correlation was available for 42 kidneys in 21 patients. Paired receiver operating characteristic (ROC) analyses were performed to evaluate RAR and minimum, average, and maximum early systolic acceleration in these 42 kidneys.
RESULTS
Minimum early systolic acceleration was a better test than RAR (P = .05). Minimum early systolic acceleration plus RAR resulted in improved sensitivity for detection of RAS, but this improvement was not significant (P = .16).
CONCLUSION
Minimum early systolic acceleration is the ultrasonographic method of choice to screen for RAS. RAR may provide marginal improvement in sensitivity but is probably not warranted in most clinical situations.
目的
比较通过对肾主动脉进行多普勒检查与对肾段血管进行多普勒超声检查来诊断肾动脉狭窄（RAS）的效果。
材料与方法
对186例患者获取了肾主动脉与主动脉的收缩期峰值流速比（RAR）以及肾段动脉的早期收缩期加速度。对21例患者的42个肾脏进行了传统血管造影相关性分析。对这42个肾脏的RAR以及最小、平均和最大早期收缩期加速度进行了配对受试者操作特征（ROC）分析。
结果
最小早期收缩期加速度是比RAR更好的检测指标（P = 0.05）。最小早期收缩期加速度加上RAR可提高检测RAS的敏感性，但这种提高并不显著（P = 0.16）。
结论
最小早期收缩期加速度是筛查RAS的首选超声检查方法。RAR可能在敏感性方面略有提高，但在大多数临床情况下可能并不必要。
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